HomePatient Registration Patient Registration Web Site Our belief is that all of us have a right to access basic health care, and our tradition has given us Ayurveda. Through this program, we help patients get access Schedule E1 Drugs under the best Ayurvedic doctors. Email Address * Title Choose One Mr. Ms. Mrs. Prof. Dr. First Name * Last Name * Contact Number * Reason for use. Prescribed by Dr. Anxiety Depression Insomnia Indigestion Stress Post Traumatic Stress Disorder – PTSD Digestive Disorder Pain Management Reduce Inflammation Arthritis UTI – Urinary Tract Infections Others Gender Male Female Transgender Upload Valid ID Add Files Please upload valid photo id Patient Age Marital Status Single Married Widowed Separated Divorced Others Blood Pressure (mm Hg) Heart Rate Weight (kg) Height (ft) Blood Sugar (gm/dl) Bowel Habit Proper Dry Hard Paste Rate your sleep (1 insomnia – 5 deep sleep) 1 2 3 4 5 Appetite Variable Excessive Unbearable Slow but Steady Sleep Habit Disturbed Delayed Deep Do You Dream No Dream Moderate Lots Of Dreams Urine Yellow Pale Yellow Painful Urination Paste Dietary Preference Vegetarian Non Vegetarian Mixed Thirst Variable Excessive Normal Scanty Any previous experience in using cannabis in any form? Any allergies? If yes please give details Current medication? If any please give details I Agree to be Contacted by email or phone * Yes No Information Summary
